Medication competency of nurses according to theoretical and drug calculation online exams: A descriptive correlational study
Introduction
Medication administration is one of the most important tasks and responsibilities of registered nurses (Sung et al., 2008). At the same time, medication errors are an internationally significant cause of morbidity and mortality in hospitalized patients (Kohn et al., 2000) and especially in IV therapy (Dennison, 2007, McDowell et al., 2010). All registered nurses and midwives (henceforth nurses) in Finland are trained to be responsible for performing medication. Their expertise in medication, compared to other nurses (practical nurses, enrolled nurses, etc.), is intravenous (IV) therapy.
According to previous studies, nurses lack theoretical knowledge (Morrison-Griffiths et al., 2002, Brady et al., 2009, Keers et al., 2013) and drug calculation skills (Grandell-Niemi et al., 2006, Wright, 2007). Knowledge-based mistakes do occur (Taxis and Barber, 2003), and drug calculation is also a crucial skill as one mistake in calculation can lead to a fatal medication error (Glaister, 2007, McMullan et al., 2011). Hence, adequate medication competence is the basis for safe medication practice (Sulosaari et al., 2014). In this study, the focus is on nurses' theoretical knowledge and drug calculation skills in medication.
Section snippets
Background
Medication administration involves both the intellectual activity and the physical act of medication preparation or administration (Brady et al., 2009). In the literature, medication competence is defined as a complex combination of knowledge, skills, performance, values, attitudes, and decision-making competence (Cowan et al., 2005, Sulosaari et al., 2011).
The medication competence of nurses appears to vary depending on training and experience (Veräjänkorva, 2003, Khomeiran et al., 2006, Dyjur
Aim
The aim of the study was to describe the medication competence of nurses according to the theoretical and drug calculation online exams.
More specifically, the research questions of the study were as follows:
- 1.
What is the nurses' theoretical medication knowledge according to the online exam?
- 2.
What is the nurses' drug calculation skill level according to the online exam?
- 3.
What characteristics of the nurses or the exam are related to their medication competence according to the online exam
Design
A descriptive
Demographics
Table 2 presents the characteristics of the respondents.
Age at the time of answering (Min = 22; Max = 68 ; Mean = 42.08; SD = 10.61) were distributed into four groups with 10-year intervals. There were differences between the age of participants and the units (N = 2479; F = 10.431, df = 4, sig < 0.001). In the outpatient units, the mean of age (45.07 years) was almost 5 years more than in the acute care units (40.63) and in the clinical units (40.93).
Nurses' Theoretical Medication Knowledge According to the Online Exam
There was positive correlation between the drug calculation
Theoretical Knowledge Based on Results of This Study
The results of this study indicate that the majority of nurses master the theoretical knowledge needed in medication administration as defined by Finnish Ministry of Social Affairs and Health (2009). Theoretical knowledge is considered to be the basis of safe medication (Brady et al., 2009). Since the theoretical exam of this study had a conscious focus on IV therapy, which in particular has been proven to be a risk to medication safety (Taxis and Barber, 2003, Dennison, 2007), the nurses'
Limitations
The limitations of the study include the use of a single instrument to measure theoretical competence and drug calculation skills. The data for this study were collected from those exams only and from a restricted part of Finland. Hence, careful consideration is needed to determine whether the findings can be generalized to the whole population.
No conclusions can be made on nurses' overall competence in medication administration. Implementation of safe patient medication requires a number of
Conclusions
Medication administration is a complex procedure where theoretical knowledge and drug calculation skills act as equally important areas of competence. According to this study theoretical knowledge and drug calculations skills have positive correlation. The differences in theoretical knowledge and drug calculation skills found in this study were statistically significant, but not high. These results can be regarded as excellent from the point of view of medication safety. Nevertheless, even the
Conflict of Interest Statement
No conflict of interest has been declared by the authors.
Funding Statement
State Research Funding, Finland.
Acknowledgements
The authors would like to thank Lingsoft—company for editing of English language.
References (32)
- et al.
Competence in nursing practice: a controversial concept--a focused review of literature
Nurse Educ. Today
(2005) The presence of mathematics and computer anxiety in nursing students and their effects on medication dosage calculations
Nurse Educ. Today
(2007)- et al.
Finnish nurses' and nursing students' mathematical skills
Nurse Educ. Today
(2006) - et al.
Nurses' educational preparation for a medication education role: findings from a national survey
Nurse Educ. Today
(2001) - et al.
The effect of an interactive e-drug calculations package on nursing students' drug calculation ability and self-efficacy
Int. J. Med. Inform.
(2011) - et al.
Pre-registration nurse education in pharmacology: is it adequate for the roles that nurses are expected to fulfil?
Nurse Educ. Today
(2002) - et al.
Medication education in nursing programmes in Finland—findings from a national survey
Collegian: J. R. Coll. Nurs. Austr.
(2014) - et al.
Blended learning on medication administration for new nurses: integration of e-learning and face-to-face instruction in the classroom
Nurse Educ. Today
(2008) Student nurses need more than maths to improve their drug calculating skills
Nurse Educ. Today
(2007)Do calculation errors by nurses cause medication errors in clinical practice? A literature review
Nurse Educ. Today
(2010)
Understanding experience in nursing
J. Clin. Nurs.
Becoming a web-based learner: registered nurses' experiences
J. Adv. Nurs.
A literature review of the individual and systems factors that contribute to medication errors in nursing practice
J. Nurs. Manag.
Understanding and Conducting Research in the Health Sciences
A medication safety education program to reduce the risk of harm caused by medication errors
J. Contin. Educ. Nurs.
Maths for medications: an analytical exemplar of the social organization of nurses' knowledge
Nurs. Philos.
Cited by (15)
Impact of 3D Simulation Game as a Method to Learn Medication Administration Process: Intervention Research for Nursing Students
2022, Clinical Simulation in NursingCitation Excerpt :It is comparable to traditional learning methods, for example, reading online material, but this research shows that both methods are equally good. The findings support previous findings on the versatile use of learning methods (Koivisto et al., 2018; Lee & Quinn, 2019; Salovaara-Hiltunen et al., 2019) and increased understanding that safe MA requires a multi-stage understanding and broad understanding of the MA process (Härkänen et al., 2016; Sneck et al., 2016). In this study, the theoretical knowledge of the MA process was basically on a good level among the students.
Medication competence: a concept analysis
2022, Nurse Education TodayCitation Excerpt :The Joint Commission (2020), also affirms that medication errors continue to be a critical concern to healthcare organizations. Nurses globally are on the frontline of medication administration and are often viewed as the patient's guardian to defend against medication errors within the complex, multifaceted healthcare system (Sneck et al., 2016; Sulosaari et al., 2010). Nurses spend over 40% of their work activities administering medications to patients (Sears et al., 2016).
A national approach to medicines information research: A systematic review
2018, Research in Social and Administrative PharmacyCitation Excerpt :A majority of pregnant women experienced the need for MI during pregnancy, especially women with medical problems and those having lower health literacy (n = 2).62,79 Studies on HCPs' competence focused on patient counseling (n = 13)14,16,58,81–90 and pharmacotherapy (n = 12) (Table 2, Appendix B).91–102 Patient counseling competence studies focused on undergraduate pharmacy education (n = 7)14,58,81–84,88 and continuing education for pharmacists (n = 4).16,85–87
Factors Associated With Radiographers' Intravenous Pharmacotherapy Theoretical Competence: A Comparative Repeated-Measures Study
2017, Journal of Radiology NursingCitation Excerpt :Better theoretical medication competence, clinical experience, postgraduate specialization, working in hospitals, and continuing education have been linked with fewer errors (Hsaio et al., 2010; Keijsers et al., 2015; Simonsen, Johansson, Daehlin, Osvik, & Farup, 2011). On the other hand, Sneck et al. (2016) found that younger nurses achieved better results in theoretical examinations (Sneck, Saarnio, Isola, & Boigu, 2016). In addition, several studies have reported how suboptimal theoretical medication competence has been addressed for physicians and nurses (Alshammari et al., 2015; Keijsers et al., 2015; Simonsen, Daehlin, Johansson, & Farup, 2014).
- 1
Study design, data collection, data analysis, drafting of manuscript.
- 2
Supervision.
- 3
statistics expert.